NPI | 1225654874 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX V0538) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 125.076299) |
Enumeration Date | 2020-06-19 |
Last Update Date | 2025-07-09 |