| NPI | 1669420485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G75478) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G75478) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2020-02-06 |