NPI | 1447212147 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NY 208664) |
Additional Taxonomies | 174400000X Specialist (Licence: NY 208664) |
Enumeration Date | 2006-04-06 |
Last Update Date | 2021-04-02 |