| NPI | 1912165374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME147468) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2021011453) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD476131) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 90492) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 21001) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 36119316) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T3054) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D79395) | |
| 208M00000X Hospitalist (Licence: FL ME147468) | |
| Enumeration Date | 2008-06-01 |
| Last Update Date | 2025-06-13 |