| NPI | 1265546188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 30351) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MN 30351) |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: MN 30351) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2023-09-01 |