| NPI | 1174726749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: GA 59348) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: GA 059348) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2018-01-04 |