| NPI | 1255589891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 43006) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: KY 43006) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2018-10-24 |