| NPI | 1528226388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: FL ME113968) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME113968) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0116023364) | |
| 2084P0301X Psychiatry & Neurology, Brain Injury Medicine (Licence: FL ME113968) | |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2021-05-24 |