| NPI | 1407842032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: TX P9604) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA 33809) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA 33809) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX P9604) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX P9604) | |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: IA 33809) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2016-04-04 |