| NPI | 1437643004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A177584) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT216613) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2024-12-07 |