| NPI | 1326186073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A75879) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: CA A75879) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2008-02-28 |