| NPI | 1497275622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 286738) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 271069) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2022-04-08 |