| NPI | 1003194549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: FL ME132375) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 28375) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL ME132375) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MO 2020038636) | |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2022-07-21 |