| NPI | 1982923785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX Q9271) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 244435) |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2016-08-18 |