| NPI | 1417120866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: MN 64725) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A117400) |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2019-12-18 |