| NPI | 1437774585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301514592) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.150477) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME167083) | |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2025-10-02 |