| NPI | 1316106859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A121594) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-236227) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 236227) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 243745) | |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2019-04-29 |