| NPI | 1770557316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ME MD17268) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 57645) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2018-02-21 |