NPI | 1134236102 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME175013) |
Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX 41443) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX N2967) | |
207T00000X Neurological Surgery (Licence: TX N2967) | |
Enumeration Date | 2006-08-24 |
Last Update Date | 2025-09-30 |