NPI | 1518156967 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: KY 45298) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2007-01465) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: KY TP556) | |
Enumeration Date | 2007-10-22 |
Last Update Date | 2020-04-23 |