| NPI | 1780623603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.082138) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35082138) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2021-03-23 |