| NPI | 1578781209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: KS 04-37076) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 946507) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 259461) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2016-04-28 |