NPI | 1194702381 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01045219A) |
Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: IN 01045219A) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 32468) | |
2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01045219A) | |
Enumeration Date | 2005-12-28 |
Last Update Date | 2024-10-29 |