NPI | 1962834796 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD61054444) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 33238) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD226000) | |
Enumeration Date | 2013-08-02 |
Last Update Date | 2025-07-23 |