| NPI | 1558628081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: OH 35135254) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 50316) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 282588-1) | |
| Enumeration Date | 2012-04-22 |
| Last Update Date | 2020-04-13 |