| NPI | 1669566147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A72794) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A72794) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2021-07-01 |