| NPI | 1053675207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: NY 285120) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: IA MD46055) |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: NC 2020-03371) | |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: FL ME-145832) | |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: MN 65316) | |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: CA A143024) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 68643) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 70763) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.134980) | |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2025-05-31 |