| NPI | 1215319710 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 86603) | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 55785) | 
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036.152567) | |
| 207R00000X Internal Medicine (Licence: IL 036.152567) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2022-00067) | |
| Enumeration Date | 2015-06-22 | 
| Last Update Date | 2024-10-11 |