| NPI | 1952720104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T1068) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: TX T1068) |
| 208D00000X General Practice (Licence: NE 28833) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2022-07-18 |