| NPI | 1700413184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME161805) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: FL ME161805) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2023-09-28 |