| NPI | 1861660987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 238794) |
| Additional Taxonomies | 2084N0600X (Licence: NY 238794) |
| 2084N0600X (Licence: OH 34.013473) | |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2025-07-11 |