NPI | 1629289178 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA A90493) |
Additional Taxonomies | 2084P0005X Psychiatry & Neurology Neurodevelopmental Disabilities (Licence: CA A90493) |
Enumeration Date | 2007-05-25 |
Last Update Date | 2020-01-16 |