| NPI | 1679913586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA C181399) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 288021) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD2024-0726) | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2024-08-23 |