| NPI | 1134306566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: SC 40035) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME103219) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: CA A119741) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: TX P7219) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: SC 40035) | |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2022-11-15 |