NPI | 1083136535 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 69633) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 30733) |
Enumeration Date | 2017-07-15 |
Last Update Date | 2021-08-30 |