NPI | 1245637784 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A155281) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 880229) |
207R00000X Internal Medicine (Licence: CA A155281) | |
Enumeration Date | 2014-11-26 |
Last Update Date | 2025-07-07 |