| NPI | 1174564983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI MD09296) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: RI MD0926) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2022-08-25 |