| NPI | 1306052345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX T8715) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.116412) |
| 207R00000X Internal Medicine (Licence: IL 125-046330) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: IL 125-046330) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IL 036116412) | |
| 208M00000X Hospitalist (Licence: IL 036.116412) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2023-02-23 |