| NPI | 1093210775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 65996) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 29185) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MN 65996) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 29185) | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2024-06-24 |