| NPI | 1407119258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: TX 47786) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: TX 47786) |
| 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: VA 0101269400) | |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2022-09-06 |