| NPI | 1811370240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: AL 43649) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 43649) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101287798) | |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2025-10-30 |