| NPI | 1710204953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2014-00581) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: NC 2014-00581) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101265689) | |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2021-10-25 |