NPI | 1104035468 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA A109028) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 4301083502) |
Enumeration Date | 2007-05-22 |
Last Update Date | 2015-06-25 |