| NPI | 1730344789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 5101016016) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA 20A9440) |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2016-06-22 |