| NPI | 1255565875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA C167338) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 56196) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301111624) | |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2023-09-21 |