| NPI | 1487823720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: FL ME147998) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 390200000) |
| 207T00000X Neurological Surgery (Licence: TX R1484) | |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2021-01-20 |