| NPI | 1235177353 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 079237)  | 
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: CT 079237)  | 
| Enumeration Date | 2006-06-02 | 
| Last Update Date | 2025-10-01 |