| NPI | 1073964847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.141075) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0063762) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO 0063762) | |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2021-01-25 |