| NPI | 1730749078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: MA 1016246) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 5151014156) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2023-06-22 |