| NPI | 1801277918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 67683) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125067527) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2020-06-29 |