NPI | 1710298138 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL 114630) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2010019767) |
Enumeration Date | 2010-06-30 |
Last Update Date | 2013-04-08 |