| NPI | 1043327489 |
|---|---|
| Doing Business As | |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 44857) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 44857) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2023-10-09 |