| NPI | 1992728448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME47929) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME0047929) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2015-06-25 |