| NPI | 1477604080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G77432) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G77432) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2007-07-09 |