| NPI | 1568480689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 39263) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX K4452) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-16336) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2026-02-26 |