| NPI | 1205899846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 47972) |
| Additional Taxonomies | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: MA 47972) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2022-01-12 |