| NPI | 1063460251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: DC MD18812) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA G151743) |
| 174400000X Specialist (Licence: MD D0038530) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2022-12-15 |