| NPI | 1568480838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA a83199) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME164233) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 32375) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: HI 14284) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 339090) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2024-02-16 |