| NPI | 1942542196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: OH 012670) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: IL 125.062608) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2022-07-21 |