| NPI | 1780782912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 13876) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VT 0420011728) |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: NH 13876) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-10-14 |