| NPI | 1003835612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 12825) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AL MD12825) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2018-07-25 |