| NPI | 1265886287 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 30912) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.130278) | 
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: GA 30912) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 57.027241) | |
| 208M00000X Hospitalist (Licence: GA 30912) | |
| Enumeration Date | 2016-04-15 | 
| Last Update Date | 2025-08-18 |