| NPI | 1124260773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology Neurocritical Care (Licence: FL ME124086) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME124086) |
| Enumeration Date | 2009-03-28 |
| Last Update Date | 2020-02-05 |