NPI | 1598729220 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME161670) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 77788) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ MA07078200) | |
2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 205562) | |
2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: VA 0101276333) | |
Enumeration Date | 2006-04-12 |
Last Update Date | 2025-03-05 |