| NPI | 1073778627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME162803) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 00000) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2018-02750) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NC 2018-02750) | |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2023-06-13 |