| NPI | 1023202843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: HI MD8443) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G82098) |
| 208D00000X General Practice (Licence: CA G82098) | |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2012-05-29 |