| NPI | 1881042968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A186640) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA R-10545) |
| Enumeration Date | 2016-05-30 |
| Last Update Date | 2024-02-21 |