NPI | 1962842567 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 288504) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI DO00905) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 288696-1) | |
Enumeration Date | 2013-06-27 |
Last Update Date | 2024-11-08 |