| NPI | 1518975036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME130810) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD028058E) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: PA MD028058E) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2018-04-09 |