| NPI | 1750374039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 27396) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35060067) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01042624A) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY 27396) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OH 35.060067) | |
| 2084H0002X Psychiatry & Neurology, Hospice and Palliative Medicine (Licence: KY 27396) | |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2016-06-28 |