| NPI | 1063779213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME150107) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OR MD184313) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2021042453) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 92528) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T5282) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD475163) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 21515) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD184313) | |
| 208M00000X Hospitalist (Licence: FL ME150107) | |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2025-06-16 |