| NPI | 1912298423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: TX T6797) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: NH 17243) |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: VT 042.0016128) | |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2024-09-16 |