| NPI | 1740854405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME167838) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 74982) |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2025-09-09 |