| NPI | 1154347011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: OH 35094617) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: AL MD.35092) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME159333) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 4301078362) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2024-04-28 |