NPI | 1912340654 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NY 289217) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 289217) |
Enumeration Date | 2013-04-11 |
Last Update Date | 2020-01-14 |