| NPI | 1922660950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: UT 13875272-1205) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NV 23875) |
| Enumeration Date | 2019-06-29 |
| Last Update Date | 2024-06-30 |