| NPI | 1548238967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 60457) |
| Additional Taxonomies | 2084N0600X (Licence: MA 60457) |
| 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: MA 60457) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2024-04-04 |