| NPI | 1952616690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 66845) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301097171) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 64398-20) | |
| Enumeration Date | 2010-08-18 |
| Last Update Date | 2022-05-18 |