| NPI | 1366974867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME157636) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036.154892) |
| 208M00000X Hospitalist (Licence: FL ME157636) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 114034) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T8726) | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2025-06-13 |