| NPI | 1518192533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35121619) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 46546) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01073180A) | |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2026-08-06 |