NPI | 1336563295 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD474263) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA11595500) |
Enumeration Date | 2014-02-13 |
Last Update Date | 2024-08-13 |