| NPI | 1245692565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: KY 54153) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY R4147) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 54153) | |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2023-09-27 |