| NPI | 1174028963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MA 291928) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME181381) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 80603) | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2026-08-19 |