| NPI | 1366608713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: FL ME132048) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME132048) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 100579) | |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2023-07-25 |