| NPI | 1518452648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MO 2022014802) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2018022151) |
| Enumeration Date | 2018-07-01 |
| Last Update Date | 2022-06-07 |