| NPI | 1780664441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 268007) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 002513-1) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NY 268007) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2015-10-14 |