| NPI | 1831753227 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME161239) | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.147806) | 
| 208M00000X Hospitalist (Licence: FL ME161239) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD221541) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 1831753227) | |
| Enumeration Date | 2019-05-01 | 
| Last Update Date | 2025-06-13 |