| NPI | 1629572029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MI 4301509185) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301509185) |
| 207R00000X Internal Medicine (Licence: IL 125.071736) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2023-07-12 |