| NPI | 1598792004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 10789) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 157794) |
| 207R00000X Internal Medicine (Licence: MA 157794) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2025-10-16 |