| NPI | 1326212689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME133931) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125053780) |
| 207R00000X Internal Medicine (Licence: SC 37165) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: SC MD37165) | |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2019-06-04 |