| NPI | 1619137965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: OH 35.123976) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL ME 113173) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.123976) | |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2014-07-31 |