| NPI | 1912433947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A171493) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 0450285) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2025-05-21 |