| NPI | 1346655511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-13086) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301104705) |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2020-07-28 |