| NPI | 1366434912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35046011S) |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: OH 35046011) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2008-08-13 |