| NPI | 1548407695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: IL 036.153564) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 237229) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.120925) | |
| Enumeration Date | 2009-01-12 |
| Last Update Date | 2023-10-23 |