| NPI | 1093109563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: MA 291645) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: DC MD048939) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 291645) | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2022-08-12 |