NPI | 1437779170 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME176727) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV 35139) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.153918) | |
2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A192787) | |
2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 85479-20) | |
Enumeration Date | 2020-04-22 |
Last Update Date | 2025-09-09 |