| NPI | 1740436971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2013006235) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NM RS2008-0416) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX BP10043934) | |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2016-08-17 |