| NPI | 1073908869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A196026) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301507824) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2026-02-17 |