| NPI | 1427334838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.120892) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD442914) |
| Enumeration Date | 2011-10-30 |
| Last Update Date | 2022-01-05 |