| NPI | 1154610814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA OP60739312) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: WA OP60739312) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2019-01-23 |