| NPI | 1740714054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: PA MD484762) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME157406) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: CO DR.0064588) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MD484762) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: MO 2022048505) | |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2024-07-11 |