| NPI | 1861631590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NC 2017-01736) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT192008) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: NY 270463) | |
| 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: NC 2017-01736) | |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2021-04-21 |