| NPI | 1184930133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV 26168) |
| Additional Taxonomies | 2084N0600X (Licence: OH 35133684) |
| 2084N0600X (Licence: WV 26168) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 3269) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35133684) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101279544) | |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2023-11-16 |