| NPI | 1093790677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: GA 89856) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: PA MD061548L) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2023-10-31 |