| NPI | 1982108981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A174703) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL MED160016) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2023-02-21 |