| NPI | 1750813630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: OH 35.141902) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 81840) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 81840) | |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: WI 81840) | |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2026-09-02 |