| NPI | 1427242536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL ME119143) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ME MD25043) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME119143) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: VA 0101268465) | |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2022-08-22 |