| NPI | 1770897522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 74181) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 36180) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 74181) | |
| 174400000X Specialist (Licence: GA 74181) | |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2015-08-12 |