| NPI | 1225558380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2020037874) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2017020309) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.142702) | |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2025-09-19 |