| NPI | 1023138799 |
|---|---|
| Former Name | CATHERINE MICHELLE LAVIGNE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD218681) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 251607) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2018-01464) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2025-05-21 |