| NPI | 1245400209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD28193) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 57.008415) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD28139) | |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2015-09-17 |