| NPI | 1003094046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 20A 10573) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV SL0452) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV DO1440) | |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2016-11-07 |