| NPI | 1114457322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 0448063) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125070276) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 64441) | |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2023-08-07 |