| NPI | 1194257741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME162637) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A162136) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 82141) | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2023-10-31 |