| NPI | 1710481619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: NE 36208) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA 52901) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 65809) | |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2024-07-05 |