| NPI | 1770684326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A102040) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR BH8093320) |
| 207Q00000X Family Medicine (Licence: CA A102040) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2018-01-11 |