| NPI | 1407172521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX R3619) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN MD51275) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101258163) | |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2022-03-28 |