| NPI | 1528050283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 75041) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX L4510) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2024-04-08 |