| NPI | 1972525939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 169108) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX k7981) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2026-06-22 |