| NPI | 1427570977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME155946) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: FL ME155946) |
| 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: LA 327424) | |
| Enumeration Date | 2017-07-15 |
| Last Update Date | 2024-07-12 |