| 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: NC 2020-03520) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 86392) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101268953) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.139105) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 269096) | |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2024-05-01 |