| NPI | 1669772331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA 20A13423) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA 13423) |
| Enumeration Date | 2010-10-28 |
| Last Update Date | 2021-11-05 |