| NPI | 1063610673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: WV 24826) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: WV 24286) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2022-03-21 |