NPI | 1235123605 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM 92256) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX K2499) |
Enumeration Date | 2005-08-31 |
Last Update Date | 2019-08-09 |