| NPI | 1326238999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301090546) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301090546) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2019-01-10 |