NPI | 1124097225 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: CA C169966) |
Additional Taxonomies | 2085N0700X (Licence: MI 4301088851) |
207T00000X Neurological Surgery (Licence: MI 4301088851) | |
2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301088851) | |
2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MI 4301088851) | |
Enumeration Date | 2006-03-14 |
Last Update Date | 2025-04-18 |