NPI | 1376656728 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX N1260) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN MD0000030955) |
Enumeration Date | 2006-08-17 |
Last Update Date | 2012-06-12 |