| NPI | 1629235825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A90287) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: CA A90287) |
| 2084N0600X (Licence: CA A92087) | |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2021-12-01 |