| NPI | 1770752248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60118975) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A102993) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301083145) | |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2021-10-11 |