| NPI | 1669409702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 37006) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX K5794) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01069859A) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2016-07-11 |