| NPI | 1275797680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: TX P7838) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10031447) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2023-05-08 |