| NPI | 1285297135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A195200) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA HS000240L) |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2024-10-03 |