NPI | 1487691127 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME96249) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 213582) |
Enumeration Date | 2006-06-01 |
Last Update Date | 2024-03-29 |