| NPI | 1265922264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T8878) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10065271) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2023-04-17 |