| NPI | 1417393919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: CA 20A16571) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 573287) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 20A16571) | |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: TX S7109) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX S7109) | |
| Enumeration Date | 2013-05-12 |
| Last Update Date | 2025-06-30 |