| NPI | 1801987748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME46165) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME0046165) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2022-11-01 |