| NPI | 1285096404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: TX V6699) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301505926) |
| Enumeration Date | 2016-03-26 |
| Last Update Date | 2025-06-20 |