NPI | 1528389244 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 55365) |
Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: MN 55365) |
Enumeration Date | 2010-06-16 |
Last Update Date | 2021-06-02 |