| NPI | 1710927850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X (Licence: AL 20152) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A84200) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 20152) | |
| 2084N0600X (Licence: CA A84200) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2025-09-11 |