| NPI | 1699096545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: NH 19527) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 52902) |
| 207P00000X Emergency Medicine (Licence: PA MD456387) | |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2019-06-28 |