| NPI | 1174639173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: TX M6868) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: TX M6868) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2018-10-12 |