| NPI | 1780937466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: TX T8852) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301101709) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T8852) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 56354) | |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2024-04-23 |