NPI | 1912326000 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: MA 269096) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.139105) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 269096) | |
Enumeration Date | 2014-04-16 |
Last Update Date | 2025-01-29 |