| NPI | 1598127714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX S6912) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME156638) |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: FL ME156638) | |
| Enumeration Date | 2016-03-26 |
| Last Update Date | 2026-03-09 |