| NPI | 1316331861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: VA 0102209969) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 34.012529) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 34.012529) | |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: SD 14816) | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2026-09-08 |