| NPI | 1649266016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.123222) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01050191A) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 059665) | |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2014-07-07 |