| NPI | 1922233600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY TP058) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV 27089) |
| 207R00000X Internal Medicine (Licence: KY R2298) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY R2298) | |
| Enumeration Date | 2009-05-24 |
| Last Update Date | 2022-04-08 |