| NPI | 1972684082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 066191) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 48807 - 20) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 48807 - 20) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2017-08-28 |