| NPI | 1891863445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME43369) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: FL ME43369) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL ME43369) | |
| 207R00000X Internal Medicine (Licence: FL ME43369) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2009-02-24 |