NPI | 1689645541 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX R1216) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX R1216) |
Enumeration Date | 2006-01-30 |
Last Update Date | 2020-01-23 |