| NPI | 1861836819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: IN 02006598A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 311100) |
| 207P00000X Emergency Medicine (Licence: PA OS022881) | |
| 207R00000X Internal Medicine (Licence: PA OS022881) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA OS022881) | |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: NY 311100) | |
| 208600000X Surgery (Licence: NY 311100) | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2025-08-28 |