| NPI | 1538137484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60201685) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX M7291) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 39851) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2020-12-04 |