| NPI | 1497722425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME89736) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME89736) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2013-07-31 |