| NPI | 1780846303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NV 14044) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV 14044) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD440616) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: OH 57.017431) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2024035980) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2024-10-29 |