NPI | 1861057598 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SD 00016642) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 74779) |
Enumeration Date | 2019-05-08 |
Last Update Date | 2025-01-25 |