| NPI | 1710184627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MA 239763) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 49939) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 239763) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2015-01-21 |