| NPI | 1316258163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: TX Q6824) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 258266) |
| 207R00000X Internal Medicine (Licence: MO 2010019210) | |
| Enumeration Date | 2010-06-27 |
| Last Update Date | 2017-03-18 |