| NPI | 1063946382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology Neurocritical Care (Licence: PA MD481680) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN24647) |
| 2084A2900X Psychiatry & Neurology Neurocritical Care (Licence: FL ME140685) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: FL TRN24647) | |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2023-07-06 |