| NPI | 1891780706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: RI MD06881) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: RI MD06881) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI MD06881) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2014-03-28 |