| NPI | 1417443946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: VA 0101267881) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI MD21095) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 14887320) | |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2026-03-16 |