NPI | 1689646614 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60071796) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 47636) |
Enumeration Date | 2006-02-03 |
Last Update Date | 2012-05-16 |