| NPI | 1073951539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA A149300) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NC 318018) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: MA 1021221) | |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2025-03-06 |