| NPI | 1255911988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 71918) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 31611) |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2022-08-16 |