NPI | 1053873182 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CO DR.0070803) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NY 322186) |
Enumeration Date | 2019-04-06 |
Last Update Date | 2024-09-05 |