| NPI | 1427439793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX S5845) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 264251) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2021-01-29 |