| NPI | 1063468171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 227419) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 23348) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 231606) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD213319) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 76168) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2024-04-05 |