| NPI | 1912142969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX P0534) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 26534) |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2021-07-13 |