| NPI | 1396783965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35042082) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA C51466) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2008-01-07 |