| NPI | 1316524119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 71925) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 31617) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2022-08-16 |