NPI | 1356872063 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME148855) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207R00000X Internal Medicine (Licence: FL TRN25045) | |
2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD215916) | |
2084N0400X Psychiatry & Neurology, Neurology (Licence: TX U5383) | |
208M00000X Hospitalist (Licence: FL ME148855) | |
Enumeration Date | 2017-03-23 |
Last Update Date | 2025-06-13 |