| NPI | 1639211311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 68429) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G87502) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G87502) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 068429) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2024-08-15 |