NPI | 1073633624 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 25310) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 08636) |
Enumeration Date | 2007-03-29 |
Last Update Date | 2020-07-07 |