| NPI | 1114047628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G060203) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 109995) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 286684) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 04-48359) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2025-12-15 |