| NPI | 1942761283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CO DR.0070583) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0070583) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2024-04-25 |