| NPI | 1679918072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MI 4301119003) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301119003) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2020-10-19 |