| NPI | 1235175449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 42818) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 42818) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 315311) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2023-07-17 |