| NPI | 1588942643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MD453973) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: PA MD453973) |
| Enumeration Date | 2011-07-23 |
| Last Update Date | 2020-08-28 |