| NPI | 1174017172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 342049) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2018018645) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 56953) | |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2024-08-19 |