| NPI | 1750582508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME136960) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PR 17589) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: PR 17589) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2019-01-09 |