| NPI | 1386080935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: UT 10269632-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-062800) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 125-062800) | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2022-07-21 |