NPI | 1619505591 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MN 78115) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 78115) |
Enumeration Date | 2020-03-27 |
Last Update Date | 2025-07-10 |