| NPI | 1932581428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NE 7548) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX S5825) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2025-10-07 |