NPI | 1811450505 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA OS023136) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 329441) |
Enumeration Date | 2019-04-09 |
Last Update Date | 2025-09-09 |