| NPI | 1164862454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MI 4301113810) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 006700) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301113810) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: GA 77810) | |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2021-02-19 |