| NPI | 1790172179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 334807) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: FL ME150139) |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: LA 334807) | |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2023-03-12 |