| NPI | 1720495666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC MD047487) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125065993) |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2019-07-24 |