| NPI | 1376077271 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: CT 69322) | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 69322) | 
| Enumeration Date | 2017-04-18 | 
| Last Update Date | 2024-07-16 |