| NPI | 1710979091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: TX J8126) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX J8126) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2022-11-04 |