| NPI | 1972644391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX R0355) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN MD40170) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: LA 322224) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2023-01-23 |