| NPI | 1245541085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA C199561) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME170121) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC LL32936) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD222479) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35C.001814) | |
| Enumeration Date | 2010-06-26 |
| Last Update Date | 2025-07-03 |