| NPI | 1861257438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 83039) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 35162) |
| Enumeration Date | 2024-02-13 |
| Last Update Date | 2026-07-14 |