| NPI | 1598298242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME156725) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 64045) |
| 207R00000X Internal Medicine (Licence: MN 28783) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 28783) | |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2024-02-09 |