| NPI | 1659663136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA A114731) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CO DR.0060109) |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2019-10-22 |