NPI | 1871819284 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 20A13128) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0102208689) |
Enumeration Date | 2010-04-09 |
Last Update Date | 2024-09-16 |