| NPI | 1891766341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 200501039) |
| Additional Taxonomies | 2084N0600X (Licence: OH 35.079946) |
| 2084N0600X (Licence: OH 35079946) | |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2025-11-21 |