| NPI | 1124687835 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: KS 0548161)  | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 0548161)  | 
| Enumeration Date | 2019-06-07 | 
| Last Update Date | 2024-06-28 |