| NPI | 1376897645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology Neurocritical Care (Licence: GA 079019) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 07909) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: GA 079019) | |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2018-03-17 |