| NPI | 1700407939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME172952) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME172952) |
| Enumeration Date | 2020-04-28 |
| Last Update Date | 2025-07-16 |