| NPI | 1548447899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: TX N7060) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA A102356) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2024-09-13 |