| NPI | 1063420412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD-2012-0661) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: FL MD-2012-0661) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME0054686) | |
| 2084P0301X Psychiatry & Neurology, Brain Injury Medicine (Licence: FL ME0054686) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2024-05-03 |