| NPI | 1629533690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: CA A176489) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A176489) |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2023-12-22 |