| NPI | 1720064819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NC 38221) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: NC 38221) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2010-11-12 |