| NPI | 1104141944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 51224) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101258766) |
| 208M00000X Hospitalist (Licence: TN 51224) | |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2019-01-17 |