NPI | 1871848853 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MO 2012018828) |
Additional Taxonomies | 2084H0002X Psychiatry & Neurology Hospice and Palliative Medicine (Licence: NY 301718) |
Enumeration Date | 2012-07-17 |
Last Update Date | 2022-05-16 |