| NPI | 1598729220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 205562) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ MA07078200) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 77788) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: WI 77788) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: VA 0101276333) | |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2023-11-09 |