| NPI | 1487148003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 34.018118) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 5101024166) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2025-08-07 |