| NPI | 1962817130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO pending) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 6799) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 6799) | |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2019-08-08 |