| NPI | 1902904451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G039234) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G039234) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-04-20 |