| NPI | 1598920225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2021-00208) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35-120742) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101251673) | |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2023-12-08 |