NPI | 1316099153 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX J4474) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 47762) |
Enumeration Date | 2007-01-18 |
Last Update Date | 2023-11-30 |