| NPI | 1295220127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301505166) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301505166) |
| 207R00000X Internal Medicine (Licence: IL 125.072003) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 125.072003) | |
| Enumeration Date | 2018-06-23 |
| Last Update Date | 2025-09-18 |