| NPI | 1639433907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD2019-0839) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: SD 14005) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2022008706) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35130427) | |
| Enumeration Date | 2012-07-01 |
| Last Update Date | 2024-02-14 |