| NPI | 1538587852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A167538) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 287191) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA 61260177) | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2024-06-17 |