| NPI | 1790058915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 006904) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 006904) |
| Enumeration Date | 2012-02-18 |
| Last Update Date | 2024-03-18 |