| NPI | 1235629924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.139804) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: OH 35.139804) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 63652) | |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2024-04-09 |