NPI | 1811488455 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NY 326381) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: LA 341425) |
Enumeration Date | 2018-05-18 |
Last Update Date | 2024-06-19 |