NPI | 1649437211 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD 60166620) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 240196) |
Enumeration Date | 2008-05-20 |
Last Update Date | 2021-06-25 |