| NPI | 1780847376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI MD15555) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 251921) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2019-02-14 |