| NPI | 1942681838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD61223241) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: WA MD61223241) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35140345) | |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2022-02-14 |