| NPI | 1952424913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A104128) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 36615) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2021-12-14 |