| NPI | 1295881894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.143432) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01052484A) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2023-05-31 |