| NPI | 1194352351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME169705) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN31018) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2024-08-08 |