| NPI | 1215348313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME139104) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10050815) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: TX BP20054344) | |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2023-02-21 |