NPI | 1568957595 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 279643) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT216769) |
Enumeration Date | 2018-06-22 |
Last Update Date | 2021-08-27 |