| NPI | 1124460803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: FL ME146704) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME146704) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 288187) | |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2023-03-09 |