| NPI | 1043534449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: FL ME156540) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 301808) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57-017445) | |
| Enumeration Date | 2010-03-15 |
| Last Update Date | 2023-04-20 |