NPI | 1104828987 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: UT 5177727-1205) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 4301072117) |
Enumeration Date | 2005-08-11 |
Last Update Date | 2023-07-30 |