| NPI | 1922250240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA A94995) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: WA MD61054703) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: FL TPME5927) | |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2024-07-12 |