| NPI | 1417929431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD470175) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 22101) |
| 208M00000X Hospitalist (Licence: OK 22101) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2020-06-25 |