| NPI | 1851952733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 66628) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ R77462) |
| 207R00000X Internal Medicine (Licence: AZ R77462) | |
| Enumeration Date | 2019-06-22 |
| Last Update Date | 2025-10-06 |