| NPI | 1407173974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: FL ME123507) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME123507) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2025-09-02 |