| NPI | 1386758712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD00030536) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD00030536) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2024-04-11 |