| NPI | 1780991315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35-123639) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: OH 35-123639) |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2016-01-11 |