| NPI | 1669904629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: TX T1488) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX T1488) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL UO5672) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T1488) | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2025-10-13 |