NPI | 1063641835 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101256084) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60388797) |
Enumeration Date | 2009-07-14 |
Last Update Date | 2021-03-18 |