| NPI | 1447343751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX M1191) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 35436) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO 37158) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2021-10-13 |