| NPI | 1376533620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 53063) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: AZ 53063) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD00046313) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 215672) | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2020-09-08 |