| NPI | 1699074021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 269871) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301098087) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC MD042978) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MA 269871) | |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2017-04-01 |