| NPI | 1487820007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME94851) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35.088650) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME94851) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.088650) | |
| Enumeration Date | 2008-05-03 |
| Last Update Date | 2026-06-25 |