| NPI | 1124319132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: CA A100043) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NY 254497) |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2023-02-08 |