NPI | 1427035278 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 322296) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME137156) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 30150) | |
Enumeration Date | 2005-12-22 |
Last Update Date | 2020-08-17 |