| NPI | 1831610989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: SC LL51165) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: OH 35.143337) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2022-08-22 |