| NPI | 1457360836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD00044601) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A98698) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX N3788) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2018-06-29 |