| NPI | 1487946539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME124276) |
| Additional Taxonomies | 2084N0600X (Licence: FL ME 124276) |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2026-06-26 |