| NPI | 1215169974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME155523) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA MD.205842) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2010-00334) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101244159) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 100378) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI MD18915) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 39314) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036123462) | |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2023-12-06 |