| NPI | 1750874723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 66750) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: CT 66750) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2021-01-15 |