| NPI | 1003830399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2009-01357) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01070620A) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.127835) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-08-07 |