| NPI | 1457523334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35134076) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60498629) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 2585151) | |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2018-09-12 |