| NPI | 1235123555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35-082299) |
| Additional Taxonomies | 2084N0600X (Licence: OH 35-082299) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2024-08-02 |