| NPI | 1841672540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: TX V1590) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: MA 278062) |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: NM MD2020-0967) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD2020-0967) | |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2025-01-20 |