| NPI | 1740290485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A46304) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI JL053156) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2023-08-15 |