NPI | 1588641591 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101274109) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 35240) |
Enumeration Date | 2005-12-30 |
Last Update Date | 2023-08-10 |