| NPI | 1700264330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A165965) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10056525) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX BP10056525) | |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2022-07-22 |