| NPI | 1891723912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T7425) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA 227075) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: GA 70835) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA C54104) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2022-08-25 |