| NPI | 1699953372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 243530) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 236649) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301503803) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA C173186) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036156364) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA11317600) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 75046-20) | |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2022-01-14 |