| NPI | 1205148848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 258638) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA mt197677) |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2022-07-21 |