| NPI | 1174748180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: AL 28776) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: OH 35.092971) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2016-10-18 |