| NPI | 1902301690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA 20A17707) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: CA 20A17707) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2023-09-05 |