| NPI | 1144664806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 58323) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME178355) |
| 208M00000X Hospitalist (Licence: FL ME178355) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 79076) | |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2026-07-17 |