| NPI | 1174899504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: AZ 80964) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NY 003999) |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2026-07-17 |