| NPI | 1093976649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A138433) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 249634) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 237512) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2012-01273) | |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2019-10-11 |