NPI | 1760534630 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME0073757) |
Additional Taxonomies | 174400000X Specialist (Licence: FL ME0073757) |
Enumeration Date | 2007-01-18 |
Last Update Date | 2022-10-05 |