NPI | 1669091658 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036.173536) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.148541) |
2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: OH 35.148541) | |
Enumeration Date | 2020-04-10 |
Last Update Date | 2025-04-16 |