NPI | 1356399448 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO 50063) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD073763L) |
Enumeration Date | 2006-05-04 |
Last Update Date | 2021-07-22 |