| NPI | 1518156967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: KY 45298) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2007-01465) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY TP556) | |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2020-04-23 |