| NPI | 1396733713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX V0914) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 36618) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV 13781) | |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2024-05-15 |