| NPI | 1891228912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 20A20279) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR DO204112) |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2022-09-15 |