| NPI | 1306085048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 334804) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: LA 334804) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 72594-20) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036139802) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 69756) | |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2023-03-12 |