| NPI | 1184628950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35070805) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35070805) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2022-12-09 |