| NPI | 1952341067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX S3219) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101259231) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 33903) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2021-08-26 |