| NPI | 1780861807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35087119) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: IL 036-116646) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2022-10-21 |