| NPI | 1912915638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0053590) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35-087358) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 04-46789) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2022-12-02 |