| NPI | 1740469030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: FL ME142626) |
| Additional Taxonomies | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: FL ME142606) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME142606) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 20342) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 91191) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 84889) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2011-01207) | |
| 208M00000X Hospitalist (Licence: GA 84889) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2025-08-04 |