NPI | 1033506175 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL OS22478) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 20A17256) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2025036730) | |
Enumeration Date | 2015-04-15 |
Last Update Date | 2025-10-02 |