| NPI | 1881128759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME166107) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME166107) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2024-06-03 |