| NPI | 1548884828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD70125182) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC LL84298) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0073146) | |
| 207R00000X Internal Medicine (Licence: CO DR.0073146) | |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2026-07-14 |