| NPI | 1578709440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: PR 017912) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CA A115959) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: CA A115959) | |
| 208D00000X General Practice (Licence: CA A115959) | |
| Enumeration Date | 2008-12-26 |
| Last Update Date | 2022-05-27 |