NPI | 1649380619 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35-041637) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 21271) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2016-08-02 |