| NPI | 1992731913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI MD08224) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 72801) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2013-06-18 |