| NPI | 1730507930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: WI 20561) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: PA MD467191) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2021-11-22 |