| NPI | 1144280942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: WV 10069) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: OH 35-037414) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2007-07-09 |