| NPI | 1588924625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: OH 35.126219) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35 126219) |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2023-02-21 |