| NPI | 1083024145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X (Licence: CA A143344) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 20835) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A143344) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301502449) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T1593) | |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2026-03-23 |