| NPI | 1699156687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MA 263762) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology Neuromuscular Medicine (Licence: MA 263762) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2022-03-24 |