| NPI | 1801112669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A119924) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60581838) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: CA A119924) | |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2025-02-04 |