NPI | 1689036352 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: TX R7588) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MD469644) |
2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: TX R7588) | |
Enumeration Date | 2016-03-22 |
Last Update Date | 2022-11-04 |