| NPI | 1720217102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 34519) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: MI 4301117143) |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: GA 81941) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35126647) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME138305) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2019-00038) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 81941) | |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2025-03-19 |