| NPI | 1609295542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: TX R9764) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: OK 44783) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX R9764) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 44783) | |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2025-02-26 |