| NPI | 1043532369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME115049) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME115049) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME115049) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL ME115049) | |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2024-01-22 |