| NPI | 1083664874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME118247) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 036000) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 36000) | |
| 208M00000X Hospitalist (Licence: FL ME118247) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2024-05-24 |