| NPI | 1639462039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 5101019354) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MI 5101019354) |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2021-12-13 |