| NPI | 1154881860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301508881) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN28985) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL TRN28985) | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2024-07-01 |