| NPI | 1558504423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME127798) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD448012) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: PA MD448012) | |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2016-08-29 |