| NPI | 1386699072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME0065642) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: FL ME0065642) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME0065642) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2017-04-04 |