| NPI | 1528404076 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 270469) | 
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: MA 270469) | 
| Enumeration Date | 2013-05-10 | 
| Last Update Date | 2023-06-09 |