| NPI | 1932737764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME164025) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL 38689) |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2023-09-01 |