| NPI | 1548794563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL 21447) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL 21447) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 13087) | |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2025-09-09 |