| NPI | 1952337701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35076768) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 36148) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: OH 35.076768) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2017-11-13 |