| NPI | 1174082002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME167779) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: FL ME167779) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2026-06-01 |