| NPI | 1568429199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35045130S) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.045130) |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: OH 35.045130) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2025-07-22 |