| NPI | 1376785436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61047280) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.132419) |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: WA MD61047280) | |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2024-03-28 |