| NPI | 1518929249 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 52123) | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 200300649) | 
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: AZ 52123) | |
| Enumeration Date | 2006-04-06 | 
| Last Update Date | 2019-11-04 |