| NPI | 1124470489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: OH 34.016509) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.016509) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2025-03-10 |