NPI | 1104989524 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR FE153656) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2007019156) |
Enumeration Date | 2006-12-18 |
Last Update Date | 2010-12-02 |