| NPI | 1104121227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: PA MD456790) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: GA 77697) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2022-10-06 |