| NPI | 1124287164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: OH 35099164) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 4301102229) |
| 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: OH 35099164) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2023-11-03 |