| NPI | 1497748289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 22378) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G081740) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2022-05-18 |