| NPI | 1063098887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD.MD.70097238) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 181939) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0074759) | |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2026-10-08 |