| NPI | 1619232824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology Neurocritical Care (Licence: SC 81987) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: FL ME135614) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: IL AS3581875-391) | |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2022-12-20 |