| NPI | 1588004287 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: CA A164527)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 6999)  | 
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 82287)  | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A164527)  | |
| Enumeration Date | 2013-06-27 | 
| Last Update Date | 2020-10-29 |