| NPI | 1609953462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 45857-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A90899) |
| 207R00000X Internal Medicine (Licence: WI 45857-20) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A90899) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2021-01-27 |