| NPI | 1548676000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: MA 274348) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT205945) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD463734) | |
| Enumeration Date | 2014-07-06 |
| Last Update Date | 2019-04-15 |