| NPI | 1447389101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A41375) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A41375) |
| 207R00000X Internal Medicine (Licence: CA A41375) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2023-02-01 |