NPI | 1164586152 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 0425486) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2926) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 84141) | |
Enumeration Date | 2006-12-21 |
Last Update Date | 2007-07-08 |