NPI | 1639842651 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME173872) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NE TEP9178) |
Enumeration Date | 2021-07-26 |
Last Update Date | 2025-06-10 |