| NPI | 1659395713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD427536) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 002597) |
| 207R00000X Internal Medicine (Licence: PA MD427536) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2016-07-18 |