| NPI | 1003080557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T5513) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 20A12174) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 58002457) | |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2023-10-02 |