NPI | 1750743571 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0062961) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX U6209) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME162552) | |
Enumeration Date | 2016-03-22 |
Last Update Date | 2025-01-09 |