NPI | 1174794788 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D71072) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101242765) |
Enumeration Date | 2008-03-22 |
Last Update Date | 2016-04-15 |