| NPI | 1578588752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: WA MD61023900) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD61023900) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: WA MD61023900) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2021-05-20 |