| NPI | 1629430137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: WA MD61085807) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology Neuromuscular Medicine (Licence: WA MD61085807) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2022-01-13 |