NPI | 1184723553 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35074125N) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 33854) |
2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: KY 33854) | |
2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: OH 35-074125) | |
Enumeration Date | 2006-09-22 |
Last Update Date | 2011-06-17 |