| NPI | 1114346657 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: GA 109332) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA a145010) | 
| 208M00000X Hospitalist (Licence: IL 036174946) | |
| Enumeration Date | 2014-04-14 | 
| Last Update Date | 2025-09-16 |