| NPI | 1558758128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME152449) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: FL ME152449) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA12210100) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 70933) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101281590) | |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2024-12-03 |