NPI | 1366435661 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101251196) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA 32437) |
Enumeration Date | 2005-08-23 |
Last Update Date | 2021-10-01 |