| NPI | 1083136535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 100377) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 69633) |
| 207R00000X Internal Medicine (Licence: MN 30733) | |
| Enumeration Date | 2017-07-15 |
| Last Update Date | 2024-11-12 |