| NPI | 1295048833 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NC 2015-00632)  | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 53730)  | 
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA11033700)  | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 85404)  | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 60386)  | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01083737A)  | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME120081)  | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101269442)  | |
| Enumeration Date | 2010-07-25 | 
| Last Update Date | 2021-12-28 |