| NPI | 1114404571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0008X Psychiatry & Neurology Neuromuscular Medicine (Licence: KY 57694) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology Neuromuscular Medicine (Licence: CA A175632) |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2023-07-14 |