| NPI | 1518221357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 333261) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: GA 86626) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 86626) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2025-06-16 |