| NPI | 1811315112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME140308) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME140308) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2020-03-06 |