| NPI | 1174735666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: MA 49233) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: RI MD06885) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: RI MD06885) | |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: RI MD06885) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: MA 49233) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2008-11-17 |