| NPI | 1780187567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: SC 91854) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: NC 2025-00294) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 91854) | |
| Enumeration Date | 2018-03-17 |
| Last Update Date | 2025-09-05 |