NPI | 1336203868 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60941919) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A101520) |
Enumeration Date | 2006-12-20 |
Last Update Date | 2024-06-11 |