| NPI | 1457641037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NY 273745-1) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 273745-1) | |
| Enumeration Date | 2011-04-15 |
| Last Update Date | 2020-12-15 |