| NPI | 1508109018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: CA A179347) |
| Additional Taxonomies | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: CA A179347) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A179347) | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2024-08-24 |