| NPI | 1124251871 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: AL 35083)  | 
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: OH applied)  | 
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: SD 8232)  | |
| Enumeration Date | 2009-08-28 | 
| Last Update Date | 2017-10-19 |