| NPI | 1265753339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 20A19971) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 2632) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA R-8955) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA OP61342551) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL TPOS639) | |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2024-07-17 |