| NPI | 1932519287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME180049) |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: FL ME180049) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME180049) | |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2026-05-12 |