NPI | 1780832774 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 279000) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME109864) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD444947) | |
Enumeration Date | 2008-09-03 |
Last Update Date | 2015-09-03 |