NPI | 1972914844 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 69154) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME125874) |
Enumeration Date | 2014-05-14 |
Last Update Date | 2022-04-08 |