| NPI | 1417397894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME133170) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX BP2-0049354) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL 133170) | |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2018-06-06 |