| NPI | 1073142089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: WA MD.MD.7009927) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: CA 193763) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2026-07-29 |