| NPI | 1073994646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CT 67374) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-263332) |
| 2084A2900X Psychiatry & Neurology Neurocritical Care (Licence: CT 67374) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: NY 298746) | |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2021-06-10 |