NPI | 1356367684 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: GA 41153) |
Additional Taxonomies | 174400000X Specialist (Licence: GA 041153) |
Enumeration Date | 2006-07-13 |
Last Update Date | 2021-06-08 |