NPI | 1003302670 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: NJ 25MB11831000) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MB11831000) |
Enumeration Date | 2018-07-07 |
Last Update Date | 2023-12-11 |