| NPI | 1528297009 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: CA A147166) | 
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: WI 60928 - 20) | 
| Enumeration Date | 2009-07-06 | 
| Last Update Date | 2020-02-05 |