NPI | 1720439540 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MN 67068) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: KY 54857) |
Enumeration Date | 2016-06-22 |
Last Update Date | 2022-02-13 |