NPI | 1891772125 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35071599) |
Additional Taxonomies | 208D00000X General Practice (Licence: OH 35071599) |
Enumeration Date | 2005-12-28 |
Last Update Date | 2013-11-27 |