| NPI | 1770733891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MD D0090484) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 264719) |
| 207T00000X Neurological Surgery (Licence: MD D0090484) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC 149879) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NJ 25MA09531300) | |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2021-03-25 |