| NPI | 1912132572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 27607) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 57607) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2020-04-17 |