| NPI | 1578780821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI MD13622) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI LP00894) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2013-06-10 |