NPI | 1710477443 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T4110) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV SL1331) |
Enumeration Date | 2018-05-17 |
Last Update Date | 2024-06-21 |