| NPI | 1326124553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME0020888) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME20888) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2022-08-18 |