| NPI | 1093377574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A182027) |
| Additional Taxonomies | 2084N0600X (Licence: CA A182027) |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2025-09-11 |