| NPI | 1881664969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101274787) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OH 35058797) |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: OH 35058797) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35058797) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2022-08-29 |