NPI | 1164549895 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 94420) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301085782) |
Enumeration Date | 2007-03-26 |
Last Update Date | 2023-03-27 |