| NPI | 1407281124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NV 21370) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD191591) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV 21370) | |
| 282N00000X General Acute Care Hospital | |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2023-07-17 |