| NPI | 1790102028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX S1024) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: TX s1024) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2026-03-27 |