| NPI | 1386805059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: WA MD61003338) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 56955) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME129406) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MN 56955) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2021-07-28 |