NPI | 1972921591 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV 19680) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 202106) |
Enumeration Date | 2014-04-01 |
Last Update Date | 2020-07-01 |