| NPI | 1457534745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: MD D0076715) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CT 045669) |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2013-10-18 |