NPI | 1518961531 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME171759) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ME MD29004) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 37807) | |
2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD2023-0126) | |
Enumeration Date | 2005-06-08 |
Last Update Date | 2025-01-17 |