| NPI | 1740377886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry (Licence: NM MD2020-0884) |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry (Licence: CO 34652) |
| 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry (Licence: TX P4541) | |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2020-10-05 |