| NPI | 1174785513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN MD53500) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35C.001511) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD61544586) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2024-10-30 |