| NPI | 1982185443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology Neurocritical Care (Licence: CO PA0006179) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology Neurocritical Care (Licence: GA 80827) |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2020-07-02 |