| NPI | 1730594011 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: FL ME163894) | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 57314) | 
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL ME163894) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI MD20295) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 34017) | |
| Enumeration Date | 2014-06-25 | 
| Last Update Date | 2025-09-30 |