NPI | 1902295165 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 295742) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI MD20189) |
Enumeration Date | 2015-01-12 |
Last Update Date | 2025-09-24 |