| NPI | 1184661837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI MD11106) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX N5516) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 159480) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2020-09-22 |