| NPI | 1396010856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G86288) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 69777) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO CDRH.0034385) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 04-48585) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 96735) | |
| Enumeration Date | 2012-03-16 |
| Last Update Date | 2023-11-13 |