| NPI | 1477719227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX R7031) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60331616) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A119941) | |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2021-12-07 |