| NPI | 1922414796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA 20A16208) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL OS15149) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2020-11-18 |