| NPI | 1003444043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 69557) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 30772) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2021-07-13 |