NPI | 1124319132 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: CA A100043) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 254497) |
Enumeration Date | 2011-04-25 |
Last Update Date | 2023-02-08 |