NPI | 1801201025 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A187641) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 63894) |
Enumeration Date | 2014-06-26 |
Last Update Date | 2023-08-03 |