| NPI | 1932661741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 19786) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL OS22887) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036177533) | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2025-12-16 |