| NPI | 1841502069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.137551) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 274495) |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2021-05-13 |