| NPI | 1144496324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 251166) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 231682) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI MD13720) | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2018-12-18 |