| NPI | 1811001365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX L2023) |
| Additional Taxonomies | 2084P0301X Psychiatry & Neurology, Brain Injury Medicine (Licence: TX L2023) |
| 2084N0600X (Licence: TX L2023) | |
| 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: TX L2023) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2025-03-24 |