| NPI | 1770959439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: IN 01087439A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 31788) |
| 207R00000X Internal Medicine (Licence: ND RL13645) | |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: WI 22111) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL ME144750) | |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2022-10-15 |