| NPI | 1669091658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME180030) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036.173536) |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: OH 35.148541) | |
| 207P00000X Emergency Medicine (Licence: OH 35.148541) | |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2026-06-30 |