| NPI | 1881807626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: OR MD176443) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA A102056) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2016-09-07 |