| NPI | 1881745826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 238478) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 14500) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MA 238478) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-12-16 |