| NPI | 1225076839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.136213) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 04-15070) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO R5981) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2019-07-03 |