| NPI | 1952830416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI LP04002) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04002) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2022-07-08 |