| NPI | 1437179199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI MD17890) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 153765) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2026-03-16 |