| NPI | 1073046371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME168737) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.141767) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 337932) | |
| 208M00000X Hospitalist (Licence: FL ME168737) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 25709) | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2024-09-25 |