| NPI | 1215597398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A183804) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125074025) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 125074025) | |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2023-07-07 |