NPI | 1386632404 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM A109798) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 3482) |
Enumeration Date | 2005-10-12 |
Last Update Date | 2021-11-08 |