NPI | 1487654281 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD044065E) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101278954) |
Enumeration Date | 2005-07-22 |
Last Update Date | 2023-09-28 |