| NPI | 1376582353 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2012-01664)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2012-01664)  | 
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: NC 2012-01664)  | |
| Enumeration Date | 2006-06-05 | 
| Last Update Date | 2023-06-01 |