NPI | 1902858475 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MD435132) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: DE C1-0005442) |
Enumeration Date | 2006-05-16 |
Last Update Date | 2022-07-21 |