| NPI | 1366829210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MI 4301511235) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI MD18022) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME129158) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: RI MD18022) | |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2024-05-23 |