| NPI | 1164839890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA OS020775) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NC 2021-02880) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: CT 075997) | |
| 2084A2900X Psychiatry & Neurology Neurocritical Care (Licence: MO 2018004024) | |
| 2084A2900X Psychiatry & Neurology Neurocritical Care (Licence: CT 075997) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: ID OC-0405) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: MO 2018004024) | |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2024-05-22 |