| NPI | 1245211788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI DO00611) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 223324) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2019-11-14 |