| NPI | 1093079048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NC 2016-00769) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 2016-00769) |
| 207R00000X Internal Medicine (Licence: GA 005730) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: WI 3399) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: NJ 25MA11292600) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: SC 87340) | |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2023-11-07 |