NPI | 1083078869 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2020-03264) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 12288464-1204) |
Enumeration Date | 2016-04-07 |
Last Update Date | 2021-10-08 |