| NPI | 1982994448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX Q7538) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX 557756) |
| 2084N0600X (Licence: TX Q7538) | |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2025-05-05 |