| NPI | 1972206423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 77502) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 33325) |
| Enumeration Date | 2023-03-23 |
| Last Update Date | 2024-07-09 |