NPI | 1548355779 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME140304) |
Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD423347) |
Enumeration Date | 2006-10-04 |
Last Update Date | 2019-12-11 |