NPI | 1215420740 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2025034841) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD476484) |
Enumeration Date | 2018-06-09 |
Last Update Date | 2025-08-22 |