NPI | 1336135649 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 71970) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 71970) |
Enumeration Date | 2005-09-22 |
Last Update Date | 2009-02-18 |