NPI | 1801373089 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME170131) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 70880) |
Enumeration Date | 2018-07-20 |
Last Update Date | 2024-08-21 |