| NPI | 1003032111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL ME128249) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX S3985) |
| 207R00000X Internal Medicine (Licence: MI 4301087270) | |
| 207T00000X Neurological Surgery (Licence: FL ME128249) | |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: TX S3985) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2013003475) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: TX S3985) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2023-09-28 |