| NPI | 1245220060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G51831) |
| Additional Taxonomies | 2084N0600X (Licence: CA G51831) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2019-05-17 |