| NPI | 1811275076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME146469) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX Q3625) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: CA C170524) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: CA C170524) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 1066262) | |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2021-09-17 |