| NPI | 1255548319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 066395) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 066395) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: GA 066395) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2018-03-17 |