| NPI | 1316331861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: OH 34.012529) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: OH 34.012529) |
| 2084A2900X Psychiatry & Neurology Neurocritical Care (Licence: SD 14816) | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2024-01-05 |