| NPI | 1902149792 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2019-01176) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2019-01176) | 
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: NC 2019-01176) | |
| Enumeration Date | 2013-04-01 | 
| Last Update Date | 2024-07-17 |