| NPI | 1790012870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX P6822) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036167040) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101280125) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: IL 036167040) | |
| Enumeration Date | 2009-11-10 |
| Last Update Date | 2024-02-21 |