| NPI | 1982194239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA na) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL 166289) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX U9042) | |
| Enumeration Date | 2018-05-12 |
| Last Update Date | 2024-04-05 |