| NPI | 1508038431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME114580) |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry (Licence: FL ME114580) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2024-07-03 |