| NPI | 1871937367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX R1895) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 278112) |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2020-09-26 |