| NPI | 1184286833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: OH 35.149311) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2019023480) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.149311) | |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2025-08-22 |