| NPI | 1699814632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 20A10667) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM 12-2006) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2019-11-08 |