NPI | 1013295716 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MA 291171) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: VA 0102203438) |
Enumeration Date | 2011-07-28 |
Last Update Date | 2023-07-31 |