| NPI | 1134533664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 273787) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2014016493) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2021-04-23 |