| NPI | 1700316122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: AL 48949) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: WI 6630-851) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2024-06-12 |