| NPI | 1518959097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: CA A55183) |
| Additional Taxonomies | 2084D0003X (Licence: CA A55183) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A55183) | |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2012-09-09 |