| NPI | 1821593690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: OH 35.139573) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology Neuromuscular Medicine (Licence: OH 35.139573) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2023-06-26 |