| NPI | 1073909891 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101267286) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101267286) | 
| Enumeration Date | 2015-04-08 | 
| Last Update Date | 2021-07-30 |