| NPI | 1386833655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.099136) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 47437) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2026-02-18 |