| NPI | 1669772539 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.122045) | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2018-00167) | 
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: OH 35.122045) | |
| Enumeration Date | 2010-10-26 | 
| Last Update Date | 2024-08-02 |