| NPI | 1144580812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD P27670) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ R74083) |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2016-06-29 |