| NPI | 1053594655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: OK 29678) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 121841) |
| 208M00000X Hospitalist (Licence: OK 29678) | |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2023-02-21 |