| NPI | 1508279134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 83294) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125065113) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL TPME158) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 125065113) | |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2023-08-31 |