NPI | 1376640094 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: MA 223282) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 223282) |
2084N0600X (Licence: MA 223282) | |
Enumeration Date | 2006-09-17 |
Last Update Date | 2025-04-07 |