| NPI | 1790767796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX J3533) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN MD30293) |
| 2084N0600X (Licence: TX J3533) | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2024-09-27 |