| NPI | 1255479911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VT 042-0011759) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VT 060-0003181) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 15158) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2015-04-06 |