| NPI | 1477789295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 44887) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA C42789) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 44887) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C42789) | |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2009-06-08 |