| NPI | 1487068342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2025-00229) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 68457) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: OH 35C.002707) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 13458) | |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2026-08-27 |