| NPI | 1730124421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101258543) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NH 9447) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VT 042-0008970) | |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2023-08-09 |