| NPI | 1831264571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 151033) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI MD13426) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MA 151033) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-12-18 |