NPI | 1750739132 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD177596) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ZZ 95838) |
Enumeration Date | 2016-05-26 |
Last Update Date | 2016-11-17 |