| NPI | 1609899665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: SD 2380) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SD 2380) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2022-04-01 |