| NPI | 1649657396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: TX S7875) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: OH 34.013994) |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2021-07-21 |