| NPI | 1275973661 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: SC 84022)  | 
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: SC MD84022)  | 
| Enumeration Date | 2013-06-28 | 
| Last Update Date | 2021-06-01 |