| NPI | 1104277557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL UO4960) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL OS17710) |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: FL OS17710) | |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2022-02-22 |