| NPI | 1508154428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA C170183) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 04-39503) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D78917) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2020033624) | |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2021-04-09 |