| NPI | 1568569333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.090685) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35.090685) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD25171) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-12-03 |