| NPI | 1205182284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NV 19931) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301114111) |
| 207R00000X Internal Medicine (Licence: FL TRN18080) | |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2020-11-04 |