NPI | 1124045901 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A108749) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 223493) |
Enumeration Date | 2006-07-16 |
Last Update Date | 2021-12-02 |