| NPI | 1134387798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: WI 73386) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA 20A15590) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2021-09-29 |