| NPI | 1417311671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL ME169620) |
| Additional Taxonomies | 2085N0700X (Licence: TX U4596) |
| 2085N0700X (Licence: FL ME169620) | |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2024-11-26 |