| NPI | 1245442540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY TP549) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2015-00520) |
| 281P00000X Chronic Disease Hospital | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2024-11-25 |