| NPI | 1740442276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: OH 35.120302) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 264328) |
| 207P00000X Emergency Medicine (Licence: OH 35 120302) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2019-09-05 |