| NPI | 1174750376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: TX Q5539) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 262753) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME159336) | |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2023-01-20 |