| NPI | 1043051980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 80690) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 34463) |
| Enumeration Date | 2024-06-04 |
| Last Update Date | 2025-08-20 |