| NPI | 1164009692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MT235413) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: PA MT235413) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2025-06-30 |