| NPI | 1710488366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL OS20729) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NE 2125) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX U8566) | |
| 208D00000X General Practice (Licence: NE 2125) | |
| 208M00000X Hospitalist (Licence: FL OS20729) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA OP61523257) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR DO218641) | |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2026-06-12 |