| NPI | 1740238856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD034678E) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G144358) |
| 2084N0600X (Licence: CA G144358) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2026-01-13 |