| NPI | 1447425285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A111158) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: CA A111158) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2023-08-04 |