| NPI | 1609223684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI MD17095) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03673) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI LP03673) | |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2021-06-23 |