| NPI | 1457469074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A36229) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: GA 53514) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 53135) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2019-10-03 |