| NPI | 1427153212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: KY 46685) |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry (Licence: KY 46685) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: KY 46685) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2020-07-13 |