NPI | 1558712992 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 287713) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 267494) |
Enumeration Date | 2016-06-27 |
Last Update Date | 2021-05-07 |