| NPI | 1356382287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35042979) |
| Additional Taxonomies | 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: OH 35042979) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2021-01-14 |