| NPI | 1801828454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.148429) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 53983) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2023-06-23 |