| NPI | 1205129590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 62381) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME130141) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV 29261) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60604257) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 074545) | |
| 208M00000X Hospitalist (Licence: FL ME130141) | |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2022-07-21 |