| NPI | 1992709265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101-049277) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101-049277) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2014-03-03 |