| NPI | 1801814322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 226676) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: MA 226676) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2026-03-09 |