NPI | 1588983589 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: IA DO-04567) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IA DO-04567) |
Enumeration Date | 2010-05-31 |
Last Update Date | 2019-08-13 |