| NPI | 1982089009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: TX Q7249) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q7249) |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2022-02-15 |