| NPI | 1730314477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME160169) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036138299) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2023-01-16 |