NPI | 1023091477 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: TX J1083) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME88890) |
174400000X Specialist | |
Enumeration Date | 2005-11-21 |
Last Update Date | 2021-08-12 |