| NPI | 1629655840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME184002) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL ME184002) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2026-09-24 |