| NPI | 1770073694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NC 2023-00264) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2023-00264) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 5315091709) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2023-00264) | |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2023-06-22 |