| NPI | 1588014690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 64820) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2016016374) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 62552) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 282855) | |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2022-07-21 |