| NPI | 1720045123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: MA 55231) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 55231) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 55231) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MA 55231) | |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2023-06-14 |