NPI | 1467893065 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NE 30007) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA 60760566) |
Enumeration Date | 2013-07-11 |
Last Update Date | 2019-08-07 |