| NPI | 1194725754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ME MD11920) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH LT4425) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2024-11-05 |