| NPI | 1275064396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA 164164) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA NOT YET DETERMINED) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2023-10-13 |