NPI | 1376820514 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME171097) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2024048194) |
208M00000X Hospitalist (Licence: FL ME171097) | |
2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD61622830) | |
2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 262167) | |
2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.152733) | |
2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD223124) | |
Enumeration Date | 2011-11-15 |
Last Update Date | 2025-07-18 |