| NPI | 1689952343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X (Licence: CA 142131) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 142131) |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2023-11-06 |