| NPI | 1477522407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME93755) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME93755) |
| 2084N0600X (Licence: FL ME93755) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 056495) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2010-08-05 |