| NPI | 1073969523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A171709) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10056519) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA p94373) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME158808) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX BP20061823) | |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2024-03-28 |