| NPI | 1043255060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35-05-1217-D) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: OH 35-05-1217-D) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2008-03-11 |