| NPI | 1336630011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X (Licence: OH 34.016382) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA OS021936) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 34.016382) | |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2023-08-23 |