NPI | 1629175526 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME124378) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA 38362) |
Enumeration Date | 2006-09-20 |
Last Update Date | 2021-08-03 |