| NPI | 1891739108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA C26455) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA C26455) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2008-04-22 |