NPI | 1558543595 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084E0001X (Licence: IA MD-42117) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CT 046592) |
2084N0400X Psychiatry & Neurology Neurology (Licence: IA MD-42117) | |
Enumeration Date | 2007-12-01 |
Last Update Date | 2023-11-16 |