| NPI | 1740216720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX F2574) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: TX F2574) |
| 204R00000X Electrodiagnostic Medicine (Licence: TX F2574) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2012-05-28 |