NPI | 1740543784 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A162063) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD458752) |
207R00000X Internal Medicine (Licence: PA mt201945) | |
Enumeration Date | 2012-06-22 |
Last Update Date | 2023-02-17 |