| NPI | 1730167057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 10924) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL OS21234) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2025-03-05 |