| NPI | 1407010382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 3512337) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A119532) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 52010) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: OH 3512337) | |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2017-11-13 |