| NPI | 1164498747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: OH 35.093750) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD422334) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.093750) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL ME123207) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: PA MD422334) | |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2022-11-28 |