| NPI | 1982775987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA go38284) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G038284) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G038284) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2019-03-27 |