| NPI | 1952575946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 20A12087) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA OP 60316845) |
| Enumeration Date | 2008-04-21 |
| Last Update Date | 2014-09-15 |