| NPI | 1962467936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA C54655) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 28699) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 200600354) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2021-09-13 |