| NPI | 1700807260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60682113) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G048704) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: ID M12845) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2016-09-14 |