| NPI | 1952806390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 1017297) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME165784) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD218507) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA11997800) | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2024-07-01 |