| NPI | 1295114197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA A151933) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CA A151933) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A151933) | |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2025-02-04 |