| NPI | 1619382355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MO 2019011182) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: VA 0101281137) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: AL 44202) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: KY FT533) | |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2024-05-13 |