| NPI | 1881748945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA C205942) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO 47753) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2026-08-27 |