| NPI | 1841637170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD465375) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP02751) |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2021-02-04 |