NPI | 1902167323 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA RTP006157) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 284579) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 82461) | |
Enumeration Date | 2012-06-01 |
Last Update Date | 2021-02-02 |