| NPI | 1891752952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME82377) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA C128200) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2020-08-24 |