| NPI | 1306055173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 47077) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA 39013) |
| 207R00000X Internal Medicine (Licence: IA R7755) | |
| 207R00000X Internal Medicine (Licence: IA 39013) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA R7755) | |
| 207R00000X Internal Medicine (Licence: AZ 47077) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2013-06-28 |