| NPI | 1316158603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 64896) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.091824) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 42051) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL 107) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2022-05-09 |