NPI | 1174967947 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2017021296) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-12765) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 35315) | |
Enumeration Date | 2013-04-24 |
Last Update Date | 2022-04-15 |