| NPI | 1861986523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: CT 079244) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: PA MD476847) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 079244) | |
| Enumeration Date | 2018-06-17 |
| Last Update Date | 2025-03-14 |