NPI | 1306804257 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: TN 56460) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: MA 57359) |
Enumeration Date | 2006-05-02 |
Last Update Date | 2018-01-31 |