| NPI | 1619177748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: OH 35.099227) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35099227) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MI 4301104157) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: PA MD431609) | |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2023-11-03 |