| NPI | 1093178220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A168429) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY R4161) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2021-08-23 |