| NPI | 1538587803 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 285683)  | 
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: IN 02008321A)  | 
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 5101026004)  | |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: MA 130)  | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2025-02781)  | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 20A18934)  | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 02008321A)  | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 90130)  | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MB11306300)  | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 285683)  | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036155494)  | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 34.013413)  | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 315497-01)  | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 74833-21)  | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 4109)  | |
| Enumeration Date | 2014-04-02 | 
| Last Update Date | 2025-08-19 |