NPI | 1003078692 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME160057) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX N2757) |
Enumeration Date | 2008-06-26 |
Last Update Date | 2023-01-04 |