NPI | 1609182898 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.132901) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VT 042.0013078) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 53098) | |
Enumeration Date | 2010-08-25 |
Last Update Date | 2018-07-17 |