| NPI | 1134337249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 246786) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ME 017754) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2012-12-11 |