| NPI | 1891833505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: OK 24622) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-41607) |
| 207R00000X Internal Medicine (Licence: OK 24622) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2022-10-28 |