NPI | 1801273743 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A149755) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV 19556) |
Enumeration Date | 2015-04-29 |
Last Update Date | 2020-11-11 |