| NPI | 1255827432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 45739) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 276438) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2025-08-01 |