| NPI | 1013979277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 55700) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MA 55700) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2014-07-07 |